Decrepit housing threatens physical, mental health

September 26, 2011

TORONTO — The health of those who are "vulnerably housed" is just as poor as the homeless, says a recent study from researchers at Toronto's St. Michael's Hospital.

The study found that more than 85 per cent of homeless people have chronic health conditions and more than half have a mental health problem.

But those who are "vulnerably housed" - meaning they live in unsafe, unstable or unaffordable housing - have equally poor or worse health than those with no housing at all, found the study published in the International Journal of Public Health last month.

"It's something that's not as visible to us because we don't see them on the street," said Dr. Stephen Hwang, principal investigator of the study and a physician-researcher at the hospital's Centre for Research on Inner City Health.

The study is the first part of The Research Alliance for Canadian Homelessness, Housing and Health's look at 1,192 homeless and vulnerably housed single adults in Toronto, Vancouver and Ottawa. Spanning a two-year period, the study will end in December with findings on the impact of housing changes on participants' health.

The alliance is headed by Hwang and includes some of Canada's leading academic researchers and community organizations with expertise on homelessness.


The physical health of those who are vulnerably housed tended to be worse than their homeless counterparts, although their mental health was deemed to be slightly better, said Hwang. This reflects the fact there's a large number of people who are vulnerably housed.

"For every person that's homeless in Canada, there's probably 15 to 20 people who are vulnerably housed."

Health status was measured by a questionnaire that asked about pain and the ability to function and carry out activities, among other things.

The findings are important because they serve as a reminder that we need to be thinking about housing as something that affects the health of our population, said Hwang.


Housing has an impact on health and it's not just about whether it's present or absent but the quality of the housing, he said.

"I think that often (for) people living in housing in very poor circumstances, that can often have a negative impact on their health that is probably almost as bad as being homeless."

He uses the concepts of diet and health to better understand the connection between health and housing.

"Thinking about the impact of homelessness on health is kind of like talking about the impact of starvation on health," he said. "It's about healthy eating, not just starving to death. And I think we need to be thinking about healthy housing, not just about homelessness."